# OKOLONA PHARMACY LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083131593
- **Authorized official:** TONY SMITH (OWNER)
- **Authorized official phone:** (901) 831-8669

## Contact information

- **Practice address:** 210 W MAIN ST, OKOLONA, MS 38860-1425
- **Practice address phone:** (662) 447-0300
- **Mailing address:** 210 W MAIN ST, OKOLONA, MS 38860-1425
- **Mailing address phone:** (662) 447-0300

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 08/25/2017
- **Last updated:** 05/23/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 00479277 | — | MS |